Inspection on 18/10/05 for Rose Martha Care Centre

This inspection was carried out on 18th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rose Martha Care Centre 03/04/09

Rose Martha Care Centre 02/04/08

Rose Martha Care Centre 18/10/07

Rose Martha Care Centre 23/04/07

Rose Martha Care Centre 27/04/06

Rose Martha Care Centre 24/05/05

Rose Martha Care Centre 05/02/05

Rose Martha Care Centre 05/07/04

Rose Martha Care Centre 10/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Rose Martha Care Centre 64 Leigh Road Leigh On Sea Essex SS9 1LF Lead Inspector Michelle Love Unannounced Inspection 18th October 2005 08:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rose Martha Care Centre Address 64 Leigh Road Leigh On Sea Essex SS9 1LF Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01702 482252 01702 716887 Ashbourne (Eton) Limited Mrs Karen Johnson Care Home 76 Category(ies) of Dementia - over 65 years of age (76), Old age, registration, with number not falling within any other category (76) of places Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Personal care to be provided to no more than seventy six service users over the age of 65 years. (Total number not to exceed 76). Personal care to be provided to no more than seventy six service users with dementia over the age of 65 years. (Total number not to exceed 76). Number of service users for whom personal care is to be provided shall not exceed 76. (Total number not to exceed seventy six). The Registered Manager to undertake additional dementia training, which enables her to cascade training to all members of the staff team at Rose Martha Court, within three months. (by 22nd March 2005). 24th May 2005 Date of last inspection Brief Description of the Service: Rose Martha Care Centre is a purpose built establishment situated in Leigh on Sea. The home is close to local amenities and access to local bus and train routes is good. The home provides residential care for up to seventy six older people. The registration category also permits the home to provide care for older people who have dementia. The home also offers `step down`, a scheme whereby arrangements exist with the local hospital where beds are contracted for those patients who are assessed as suitable for residential care. All bedrooms have en-suite facilities for residents. The communal areas consist of two lounge and dining areas on both the ground and first floors. The home also provides a designated smoking area, visitors/hairdressing room and an activities room. Access to the first floor is via a passenger lift. The gardens are well maintained. The home offers parking to the front of the property. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out by two inspectors, Michelle Love and Carolyn Delaney. The inspection took place over fourteen hours. At this visit care records and staff employment files were inspected. In addition a tour of the premises was also undertaken by both inspectors throughout the inspection and at different times. At the time of the visit the registered manager was providing support to another local Ashbourne Healthcare home. Both inspectors were assisted by the home’s two care managers and care staff on duty. During the inspection several resident’s, members of staff and two relatives were spoken with. What the service does well: What has improved since the last inspection? What they could do better: The registered manager and registered provider must look at ways of reducing the number of repeat statutory requirements and recommendations, and Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 6 addressing continued and identified issues as highlighted at previous inspections to the care home. A number of areas need to be addressed and these include further development of pre admission assessments, care plans and risk assessments. Staff working within the home must ensure that medical advice is sought for all residents and appropriate health care is provided. The registered manager must look very carefully at the way staff work, if and how they speak to some residents, and how staff spend their time during the day. Interaction between some staff was seen to be positive, however with other members this remains very poor. Activities provided to residents must be consistent and appropriate measures must be undertaken by the registered manager/provider to ensure that all staff within the home feel empowered and able to engage residents with meaningful activities and stimulation. The numbers of hours provided by the homes activities co-ordinators is woefully inadequate to meet the numbers and needs of residents. It remains disappointing that no action has been taken by the registered provider to address this issue. Some members of staff require specialist training which meets the needs of older people and those conditions associated with older people in general. Staff recruitment procedures remain poor and inconsistent and do not offer protection for residents residing at Rose Martha Care Centre. Staffing levels must attain the minimal levels as agreed by the previous registration authority. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 and 5 New residents are admitted to Rose Martha Care Centre, following an assessment by the home as to their suitability. Although arrangements have been made to ensure that residents are assessed prior to admission, some assessments were not available on the day of inspection. It remains unclear as to whether or not prospective residents are given information and have the opportunity to visit the home prior to admission so as to make an informed choice as to whether or not Rose Martha Care Centre is a care home they wish to live in. EVIDENCE: Three pre admission assessments were inspected for those people newly admitted to the care home. The most recent admissions to the care home were for those people requiring a ‘step-down’ bed. A pre admission assessment was evident for one resident, however no assessments could be located for two people on the day of inspection. An immediate requirement notice was given to the home detailing that assessments must be completed prior to someone’s admission and that these must be available for inspection. A meeting was held with the registered manager several days after the inspection and copies of both assessments were handed to the inspector. Assessments inspected were Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 9 not detailed or comprehensive in all three instances. A nursing needs assessment/discharge records from the hospital were only available for two residents. The registered manager advised that pressure is placed upon her and the home’s management team to admit prospective residents so as not to ‘bed block’ at the local hospital. The registered manager was reminded that it is her responsibility to ensure that new residents are admitted only on the basis of a full assessment having been undertaken and that the registered person is able to demonstrate the home’s capacity to meet the assessed needs. No evidence was available to indicate that resident’s representatives/family members visited the home prior to their relatives admission. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 The care planning processes within the care home remain inconsistent. Health care needs were not fully documented for individual residents. The systems for resident consultation remain poor with little evidence to indicate that resident’s views are sought and acted upon. Not all members of staff working within the care home treat residents with respect. Medication procedures and practices in most cases were appropriate for the needs of residents. EVIDENCE: On inspection of five individual care plans and risk assessments, inconsistencies were noted whereby some elements were not completed e.g. one resident’s care plan evidenced that issues relating to recreation/social care and falls were not completed. A relative advised that they had provided information to the home pertaining to their mother’s personal preferences relating to recreation/social care (activities/hobbies). This was not detailed within the resident’s care plan. No care plan had been written for the newest resident to be admitted to the care home. It was of concern as no information was available to clearly detail the action which needs to be taken by care staff to ensure that all aspects of the persons health, personal and social care needs are met. One resident’s care plan made reference to them being a diabetic, Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 11 having a poor appetite and being at risk of pressure sores. The care plan element relating to eating and drinking did not detail that the resident was diabetic or include clear information pertaining to their nutritional needs. No evidence was available to indicate that the resident had been weighed since their admission. No formal assessments are completed in relation to pressure sores, continence or nutrition. Daily care records were not written daily for all residents and in some cases information recorded lacked detail and clarity. From inspection of one resident’s care plan, daily care records and accident records it was evident that the resident had sustained two falls within two days. Records detailed that despite not complaining of pain immediately, extensive bruising and discomfort was experienced by the resident and witnessed by care staff, however no member of staff/management thought to seek medical advice. Upon admission to hospital for a routine appointment, an x-ray was undertaken and the resident was found to have fractured their hip. Not all care plans had information relating to funeral arrangements/terminal care information for residents. Risk assessments were not available for all areas of assessed risk and/or need. No risk assessment was completed for one resident who is diabetic and who has a poor appetite. Moving and Handling assessments were evident within all care files inspected. Not all care plans/risk assessments had been updated/reviewed to reflect changes to resident’s needs. Care Managers advised the inspector’s that at the time of the inspection only one resident had a pressure sore (admitted from hospital), four residents used bed rails and two residents were prone to falls. The risk assessment pertaining to bed rails for one resident was inadequate and lacked detailed information. Since the last inspection six residents have died, however the Commission for Social Care Inspection has only received one regulation 37 notification. It was disappointing to observe once again, some staff members exhibiting very poor interaction with residents. During the inspection care staff were slow to answer one resident’s call alarm facility (4.5 minutes). Staff spoken with at the time stated when questioned, that the reason for their slowness was because the resident only wants to enquire as to where their breakfast is. Care staff, were advised that this is an assumption and not good practice and no matter who rings their call alarm, all should be answered promptly and without delay. One resident within lounge area 3 was heard to request a cup of tea. A member of care staff was overheard to say that it was not possible for the resident to have a cup of tea, as they were on their own within the lounge area. It was only when the inspector intervened and questioned as to why a cup of tea could not be made that they received one. Tea/coffee making facilities are available within each lounge/dining area. On several occasions throughout the inspection, some staff members were observed to stare out of Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 12 the window for long periods and not talk with residents until they saw inspectors present. One relative advised that despite alerting care staff on shift one Saturday that their relative wished to watch Strictly Come Dancing on television, care staff ignored the relative’s/resident’s wishes and watched X Factor instead. Medication policies and procedures within the home remain unchanged. No omissions were observed within resident’s medication administration records (MAR). Some residents self medicate (inhalers/creams) and risk assessments pertaining to their levels of competency were available. Eye drops for one resident were not stored appropriately i.e. refrigerator. Some MAR records did not include the date or signature of staff, indicating that medication received into the home was correct. One relative spoken with on the day of inspection was concerned that their relatives medication had “not consistently been offered”, however the MAR records evidenced that their medication had been refused on several occasions. No evidence of a medication review/advise from GP was available. Resident’s accident records did not always evidence staff’s interventions/care provided. Accident records since July 2005 were inspected and these evidenced that in July there were 40 accidents/incidents, August there were 83 accidents/incidents, September there were 56 accidents/incidents and up to the day of inspection there had been 34 accidents/incidents. The incidence of accidents/incidents which were falls related, were high. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 13 There is a programme of activities for residents. Activities within the local community remain fairly limited and activities for those people with complex needs/dementia have not been implemented. EVIDENCE: Recording is poor within individuals care plans/daily care records to evidence meaningful activities/occupation provided to resident’s. On the day of inspection no activities co-ordinator was available, as they had phoned in sick. The number of hours set aside for activities within the home remains inadequate for the needs and numbers of residents. This is of concern and has been highlighted at previous inspections to the home. During the inspection an agency member of staff was observed to have a game of dominoes with one resident for a short period of time. The hairdresser was visiting the home on the day of inspection and several residents were observed to have their hair cut/permed/styled. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has an adequate complaints and adult protection policy and procedures in place. EVIDENCE: Since the last inspection the home has received six complaints. At the time of the inspection the inspector was advised that one of the above complaints has as yet to be received formally and records pertaining to another complaint were unavailable for inspection as the registered manager was dealing with the issues. Records relating to the other four complaints were available within the home and related to poor food/lack of choice and care issues. Several letters/cards of compliments were seen. Not all staff within the home had received protection of vulnerable adults training. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The standard of the environment remains appropriate for the numbers and needs of residents, and provides residents with a homely and attractive place in which to live. EVIDENCE: The home continues to be well maintained and decorated for residents. All bedrooms inspected continue to be personalised and individualised for residents needs. On the day of inspection the home was observed to be clean and odour free. During the inspection several bedrooms were observed to be very cold, with windows left open and radiators cold to the touch. No bins were noted within some bathrooms. Not all bedrooms had hand towels available for residents use. This has been highlighted at previous inspections to the home. The home’s laundry area remains well organised. One problem was identified during the inspection pertaining to the smoking room on the ground floor. The care manager advised that residents like to keep the door open, however the smoke from the room could be smelt within the main reception area and past the hairdressers/visitors/conservatory area. The registered provider must find Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 16 a suitable solution and ensure that smoke from within the smoking room does not affect other areas of the home. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 No significant changes have taken place with regard to the home’s vetting and recruitment procedures, and these still remain poor with appropriate checks not being carried out and potentially leaving residents at risk. Staffing levels remain inadequate for the numbers and needs of residents. Staff training for some remains poor and inappropriate. EVIDENCE: On the day of inspection staffing levels were not in line with the minimum requirements as two members of staff had telephoned sick. Following discussion with the care manager, measures had been undertaken to seek alternative cover. An agency member of staff was seen to replace one member of staff mid-morning. On inspection of duty rosters, these were seen to contain limited information relating to who had provided cover for those members of staff receiving training/gone on sick leave. It was unclear as to who had specifically provided cover. The staff roster did not include the hours worked by the registered manager, administrative and maintenance staff employed at the care home. The roster continues to show that agreed staffing levels are not being maintained and that some care staff are leaving the premises early on the late and night shifts. In addition the deployment of senior staff i.e. care managers, needs to be reviewed to ensure that there is adequate management cover seven days a week. Some members of staff continue to work up to 57.75 hours per week and with no off duty days. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 18 Recruitment practices within the home remain poor and unsatisfactory. Gaps were evident in relation to employment histories not being fully explored, inappropriate references being sought i.e. not from most recent employer, an application form incomplete with limited information, no evidence that a criminal record bureau check had been initiated, inductions not completed in all cases, no evidence of training and past experience and no proof of identification. An immediate requirement notice was issued to the registered manager following the inspection and as a result of the Commissions continued concerns pertaining to poor recruitment practices. Of those staff files examined (night care staff x 5) it was noted that the majority of staff have received mandatory training/updates, but little specialist training which meets the specific needs of residents and those issues related to the care and conditions of older people. Not all members of staff had received training relating to protection of vulnerable adults. On the day of inspection a new agency member of staff was observed to enter the home. No formal induction was noted to have taken place and no written induction record was completed. The agency member of staff `shadowed` a member of care staff for a brief period of time and was then left unsupervised. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 and 38 Monetary records and accounts for residents are well organised and maintained and these clearly protect individual residents financial interests. Safe working practices are undertaken at the care home for some staff, but not for all. EVIDENCE: A random sample of written records and transactions pertaining to individual resident’s monies were inspected and seen to be satisfactory. Resident’s personal monies are kept securely within the home. Records were inspected in relation to hot water temperatures for wash hand basins/baths. No records were available for individual bedrooms. The majority of staff have received training for manual handling, fire safety, first aid, food hygiene, infection control and health and safety. No records were available to indicate that the home’s emergency lighting, alarms and fire extinguishers were checked on a regular basis. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 2 2 1 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 1 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14(1) Requirement Ensure that detailed and comprehensive assessments are compiled which determine that the home can meet the needs of residents. (Previous timescale of 14.6.05 not met) Ensure that all staff at the care home undertake appropriate training to the work they perform and have the necessary skills and expertise to meet the specialist needs of residents. (Previous timescale of 1.10.05 not met) Ensure that comprehensive and detailed care plans are devised for all residents. (Previous timescale of 1.7.05 not met) Ensure that risks to residents are identified and as far as possible eliminated. (Previous timescale of 1.7.05 not met) Ensure that individual care plans are reviewed and reflect changes to residents needs. Ensure that information relating DS0000015465.V266883.R01.S.doc Timescale for action 07/12/05 2 OP4 18(1)(a) 18(1)(c) 01/04/06 3 OP7 15(1) 07/12/05 4 OP7 13(4) 07/12/05 5 6 OP7 OP7 15(2)(b) 12(3) 07/12/05 01/01/06 Page 22 Rose Martha Care Centre Version 5.0 7 OP8 12(1)(a) (b) 8 OP8 37(1)(a) 9 OP7 12(4)(a) 10 OP9 13(2) 11 OP12 16(2)(m) (n) 12 OP12 18(1)(a) 13 14 15 OP18 OP19 OP19 13(6) 23(2)(p) 23(2)(p) to terminal care and funeral arrangements for residents are recorded. Ensure that proper provision is made for residents in relation to their health and welfare. This refers specifically to staff seeking medical advice from professionals. Ensure that notice is given without delay to the Commission in relation to the death of any resident. Ensure that suitable arrangements are made which enables staff to respect residents. Ensure that suitable arrangements are made for the recording and safe storage of all medicines received into the home. Ensure that residents have access to a range of activities of their choice and opportunities to access the local community. Ensure that activities are provided to those residents who have complex needs/dementia. (Previous timescale of 1.8.05 not met) Ensure that at all times sufficient numbers of staff are working at the care home as are appropriate for residents needs. This refers specifically to the limited hours set aside for activities. Ensure that all staff receive training pertaining to protection of vulnerable adults. Ensure that all areas of the home are heated appropriately for residents. Ensure that all areas of the home are ventilated. This refers specifically to the home’s smoking room. DS0000015465.V266883.R01.S.doc 07/12/05 07/12/05 07/12/05 07/12/05 01/01/06 01/02/06 01/02/06 07/12/05 01/01/06 Rose Martha Care Centre Version 5.0 Page 23 16 OP19 16(2)(j) 17 OP27 18(1)(a) 18 OP27 17(2), 4 (7) 19 OP29 17(2), 19(1) 2 and 4 18(2) 20 OP36 Ensure that suitable arrangements are made for maintaining satisfactory standards of hygiene. This refers specifically to no bins in bathrooms and no hand towels being available. (Previous timescale of 14.6.05 not met) Ensure that at all times there are suitable qualified, competent and experienced persons working at the care home in such numbers as are appropriate for the health and welfare of residents. (Previous timescale of 21.6.05 not met) Ensure that the duty roster includes the names of all staff working at the home. This refers to the registered manager, maintenance person and both administrators. Ensure that robust recruitment procedures are adopted and that records contain all information as required by regulation. Ensure that all staff receive supervision. Not inspected on this occasion. 14/12/05 01/01/06 07/12/05 07/12/05 01/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP2 Good Practice Recommendations The registered manager/care managers and senior members of care staff should not be pressured by external agencies to admit residents to Rose Martha Care Centre. The decision to admit a resident must rest with the registered provider. Ensure that evidence is recorded depicting clearly whether DS0000015465.V266883.R01.S.doc Version 5.0 Page 24 2 OP5 Rose Martha Care Centre 3 4 5 6 7 OP7 OP7 OP7 OP8 OP12 8 OP33 9 10 OP38 OP38 or not residents visited the home prior to admission/offered trial\visits/tea visits. Daily care records should be written daily for all residents. Risk assessments for the use of bed rails should be individualised for each resident and contain detailed and comprehensive information. Ensure that call alarms are answered promptly and without delay. Accident records should include information pertaining to staff interventions and care provided to residents. Care plans should include information relating to residents wishes and personal preferences re: activities. Care plans/daily care notes should include evidence of activities undertaken. Ensure that the homes quality assurance system clearly evidences how outcomes were reached. Not inspected on this occasion. Carried forward to next inspection. Ensure that hot water temperatures from residents wash hand basins and baths are individually recorded at least once monthly. Ensure that emergency lighting, alarms and fire extinguishers are tested and evidence is recorded. Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rose Martha Care Centre DS0000015465.V266883.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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